Topics: Subsequent Treatment

You probably feel on the edge of devastation. You have been betrayed in the most horrific manner. You probably do not have any coherent idea about what has happened to you and what went so very wrong.  

Most people who have been abused by their psychotherapists desperately need help to survive such traumatic abuse.  Not all victims of such abuse choose subsequent psychotherapy as their route to becoming survivors rather than victims.  If a victim dares to seek subsequent psychotherapy, the first order of business is finding a  psychotherapist who is safe and effective.  This is no easy matter when one is overwhelmed by trauma. The ability to trust one’s own judgment has been destroyed in most victims.  “I chose my abusive psychotherapist,” a victim is likely to reflect. “I trusted that therapist, and look what happened.”

 Why would any sane person take him- or herself back into anything that even remotely resembles the site of devastation?  Just thinking about a psychotherapist’s office may trigger overwhelming trauma. And then thinking that one would be alone in a room with a psychotherapist and vulnerable to being abused again can be terrifying.  “Never again” rings loud in any sane person’s mind.

But with one’s life rapidly crumbling, desperation that is not yet despair allows some victims to hope “maybe somewhere there could be someone safe.”  

“But how can I find someone safe?”

You may want to begin by speaking to a victim advocate who has already become a survivor of such abuse and get names of psychotherapists who have been shown to be safe and effective.  Going to one or more of these suggested therapists on a consultation basis may help you clarify what it is you’re seeking.

No matter how you chose your subsequent therapist, you must assess some basic things from the outset:  

  • Does this psychotherapist really know about the nature of trauma? It is not absolutely necessary that the therapist be experienced in this particular realm of trauma; however, it is imperative that the psychotherapist know the nature of trauma and what happens to a person when their world has been destroyed and their ability to trust themselves has been destroyed.  Whatever has taken you to therapy in the first place has now been made worse by the destructiveness of this abuse and now you are totally overwhelmed by trauma. This may be new trauma on top of previous experiences of trauma, or it may be the first time you have ever been traumatized.  Either way a victim of this abuse is massively traumatized, and your subsequent therapist must know that she/he must stand for reality in a quiet yet firm way.  She/he must be able to be with you and your overwhelming emotions, able to distinguish such overwhelming loss, rage, self-hatred, and self-loathing from all other forms of emotion.  

  • Your subsequent therapist must validate from the outset that you have been abused and be clear regarding the abusing therapist’s obligation to have set and maintained safe boundaries.  Eventually your subsequent therapist must help you to see how your previous therapist has taken advantage of the power that resides with all therapists. Your abusive therapist has used this power over you to manipulate you to his/her advantage.  This manipulation surely has taken many forms of which sex is only one.  

  • Your subsequent therapist must be able to use the power that comes from being the one with the expertise to help you feel safe. Since you have been abused, you most likely will not feel safe for a long time. Daring to feel hope, the only reason to seek subsequent therapy, is not at all the same as feeling safe.  Your therapist should be able to let you test his/her trustworthiness in countless ways while you slowly learn to regain trust in your own judgment.  

  • Your subsequent therapist should be able to accept that you are unlikely to trust him/her and that there is no reason for you to do so.  In fact, there is every reason not to do so.

  • Your subsequent therapist must not impose his/her agenda with regard to your abuser on you and your therapy, but rather should empower you to act, when you’re ready, on your own behalf.

  • Your subsequent therapist must be willing to allow you to talk about your therapy with outsiders and seek consultations when anything in your subsequent treatment makes you uncomfortable, and should, in fact, encourage you to do so.

  • Your subsequent therapist should be informed, from the outset, that you wish to hold open the option of taking action, including filing a lawsuit, and be comfortable with that possibility.

If you go to a subsequent therapist who makes you uncomfortable in any way, insist on talking about and exploring what has happened. Insist on an explanation. If this is not forthcoming, you owe it to yourself to leave and move on. 

Wanda Needleman, M.D.

For information on this author's perpetrator and an illustration of a case in which a licensing board took a case seriously and acted to protect the public, see: ><

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